ADDIS ABABA, ETHIOPIA —
The Ethiopian government wants a uniform health evaluation process to be introduced in all of Africa to help reduce child deaths. The idea will be recommended during an upcoming African Child Survival Conference.

One goal of the United Nation's millennium development project is to reduce the child mortality rate in sub-Saharan Africa by two-thirds by 2015. So far the reduction has been 39%. Ethiopia stands out because it already has reached a 60% reduction in the mortality rate of children under five years old. The country is hosting a conference on child survival and will suggest ways to achieve a two-thirds goal.

The U.S. Agency for International Development, known as USAID, is a partner with the Ethiopian government on the project. USAID administrator Dr. Rajiv Shah said he hopes all African countries will adopt a scorecard that publicly collects and reports health data.

“So we know where children are dying, what they are dying of and how we are making progress as efficiently and effectively as possible. Second we are asking every country to sharpen their country plans to focus on, in particular, low income children and communities and to reach them with the five, six most cost-effective and efficient interventions for savings children’s lives," said Shah. "In most countries that means tackling malaria, pneumonia and diarrhea. But also other causes like neo-natal mortality.”

Effective in Ethiopia

The scorecard consists of three components: input indicators that relate to policy issues and availability of resources; process indicators; impact and outcome indicators that outline the data results.

Ethiopia Minister of Health Kesetebirhan Admasu said the scorecard has been introduced on all governing levels in Ethiopia.

“You can really track. If you see particular indicator rate indicator at the national level, you see which parts of the country are contributing for that indicator to be right at national level," Kesete said. "So it will also give you the opportunity to make sure that you have an equitable health service delivery system. We have to also try to redress the disparities we have in different parts of the country.”

The minister believes the scorecard can be adopted in all African countries.

Helping children

Sub-Saharan Africa is lagging behind other regions of the continent in reducing under-five deaths. One in eight children in Sub-Saharan Africa still die before reaching their fifth birthday.

Ethiopia’s good results on improving health care coincide with a decade of rapid economic growth. Ethiopia also has received considerable financial aid from the West. USAID alone spent $985 million in the last three years in East African countries. But USAID does intend to reduce the dependency on foreign assistance over the next decades.

Kesete said Ethiopia's health sector is focusing on mobilizing more domestic resources.

“One of the most important interventions that would help us to mobilize more resources is health insurance scheme that we are trying to put in place. We have done it in thirteen districts in the last two years and this year we have decided to scale it up to more than 100 districts across the country,” said Kesete.

Shifting dynamics

The African continent is changing fast in several ways through economic growth and urbanization. Shah said efforts to control diseases stay the same despite these changes.

“The predominant causes of death remain infectious disease. So until you have dramatically reduced children dying from malaria, pneumonia, diarrhea and in the first 48 to 72 hours of life from a range of causes in that period, it would not be an efficient thing to do, to shift resources to higher order urban care if your goal is to save as many children’s life as possible,” said Shah.

All African health ministers are expected to attend the conference on African Child Survival in Ethiopia on January 16 thourgh 18.